MedicalResearch.com Interview with:
Neil A. Busis, M.D.
University of Pittsburgh Physicians
Department of Neurology
Chief of Neurology, UPMC Shadyside
Director of Community Neurology
MedicalResearch.com: What is the background for this study?
Response: Previous studies showed that neurologists have both one of the highest rates of burnout and the lowest rates of satisfaction with work-life balance, compared to other physicians.
The mission of the American Academy of Neurology (AAN) is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction. This is why AAN President Dr. Terrence Cascino initiated this research, to better define the issue. Our findings can guide current and future programs to prevent and mitigate neurologist burnout, promote neurologist career satisfaction and well-being, and direct efforts to advocate on behalf of neurologists and their patients.
MedicalResearch.com: What are the main findings?
Response: The study involved 1,671 neurologists with a median age of 51 years and an average 17 years in practice. 65 percent were men. Participants reported working an average of 56 hours per week, with three-fourths of that time spent in clinical care. One-third of neurologists worked in academic practice, or a university setting, and the rest in clinical practice.
The study found 60 percent of neurologists reported at least one symptom of burnout (high emotional exhaustion or high depersonalization). A majority, 53 percent, of neurologists had high emotional exhaustion, 41 percent felt high depersonalization and 21 percent had a low personal accomplishment score. Clinical practice neurologists had a higher burnout rate than academic neurologists (63 percent versus 56 percent).
Hours worked per week, nights on call per week, number of outpatients seen each week, and amount of clerical work were associated with greater burnout risk. Lower risk was associated with effective support staff, job autonomy, meaningful work, age and subspecializing in epilepsy.
Most neurologists (88 percent) reported their work is meaningful to them. A minority of neurologists indicated the amount of time spent on clerical tasks was reasonable, both directly (23 percent) and indirectly (16 percent) related to patient care. 56 percent of neurologists indicated that they had too little support staff to assist them in their work.
According to the study, effective approaches to address these issues and cultivate meaning and engagement in neurology practice could include efforts within the neurologist’s work unit and organization to improve efficiency, optimize workload, decrease clerical burden, provide greater flexibility and control over work and enhance support staff. Physician-friendly national policies that decrease regulatory burden and mandated clerical tasks would also enhance neurologists’ engagement in the practice of neurology.
MedicalResearch.com: What should readers take away from your report?
Response: The AAN is being proactive. With this data we can more effectively develop solutions to help reduce neurologist burnout and increase neurologist career satisfaction and well-being, which will improve the quality of care for patients with neurological disorders.
Under Dr. Cascino’s leadership, the AAN has compiled a variety of tips, tools, and strategies at http://www.AAN.com/LiveWell to help its members mitigate burnout and enhance career satisfaction. At the same time, the AAN is working tirelessly with policy makers in Washington, DC, to decrease the regulatory hassles neurologists face in this ever-changing health care environment so they can spend more time with their patients and less time with administrative chores.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We are currently investigating burnout, career satisfaction and well-being in residents and fellows. We would like to resurvey practicing neurologists and neurology trainees in the future to assess the impact of our programs to prevent/mitigate burnout, and enhance career satisfaction and well-being. Future surveys may also take a deeper dive into certain aspects of these issues.
MedicalResearch.com: Is there anything else you would like to add?
Response: The AAN’s advocacy efforts helped to have Congress recently pass the 21st Century Cures Act. This is great news since the Act aims to simplify the electronic health records process and decreases several other regulatory hassles.
Disclosures: Dr. Busis serves as Alternate CPT Advisor for American Academy of Neurology on the CPT Advisory Committee. CPT is operated by the American Medical Association. He receives funding for travel and honoraria for being a speaker at courses sponsored by the American Academy of Neurology.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Burnout, career satisfaction, and well-being among US neurologists in 2016
Neil A. Busis, MD, Tait D. Shanafelt, MD, Christopher M. Keran, BA, Kerry H. Levin, MD, Heidi B. Schwarz, MD,Jennifer R. Molano, MD, Thomas R. Vidic, MD, Joseph S. Kass, MD, JD, Janis M. Miyasaki, MD, Jeff A. Sloan, PhD and Terrence L. Cascino, MD
Published online before print January 25, 2017, doi: http://dx.doi.org/10.1212/WNL.0000000000003640
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